[PMID]: | 29443759 |
[Au] Autor: | Han P; Yang L; Huang XW; Zhu XQ; Chen L; Wang N; Li Z; Tian DA; Qin H |
[Ad] Endereço: | Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan. |
[Ti] Título: | A traumatic hepatic artery pseudoaneurysm and arterioportal fistula, with severe diarrhea as the first symptom: A case report and review of the literature. |
[So] Source: | Medicine (Baltimore);97(7):e9893, 2018 Feb. |
[Is] ISSN: | 1536-5964 |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | RATIONALE: Hepaticarterioportal fistula (APF) is a rare cause of portal hypertension and gastrointestinal hemorrhage, and presents as abnormal communication between the hepatic artery and portal vein. Percutaneous liver biopsy is a main iatrogenic cause of AFP. However, non-iatrogenic, abdominal, trauma-related APF is rarely reported. PATIENT CONCERNS: A 29-year-old man presenting with severe, watery diarrhea was transferred to our hospital, and his condition was suspected to be acute gastroenteritis because he ate expired food and suffered a penetrating abdominal stab wound 5 years ago. After admission, the patient suffered from hematemesis, hematochezia, ascites, anuria, and kidney failure, and he developed shock. DIAGNOSES: The patient was finally diagnosed as a traumatic hepatic artery pseudoaneurysm and APF. INTERVENTIONS: This patient was treated with emergency transarterial embolization using coils. Since a secondary feeding vessel was exposed after the first embolization of the main feeding artery, a less-selective embolization was performed again. OUTCOMES: During the 6-month follow-up period, the patient remained asymptomatic. LESSONS: A penetrating abdominal stab wound is a rare cause of hepatic APFs, and occasionally leads to portal hypertension, the medical history and physical examination are the most important cornerstones of clinical diagnosis. Interventional radiology is essential for the diagnosis and treatment of an APF. |
[Mh] Termos MeSH primário: |
Traumatismos Abdominais/complicações Falso Aneurisma Fístula Arteriovenosa Diarreia/diagnóstico Embolização Terapêutica/métodos Artéria Hepática/diagnóstico por imagem Hipertensão Portal/diagnóstico Veia Porta/diagnóstico por imagem
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[Mh] Termos MeSH secundário: |
Adulto Falso Aneurisma/diagnóstico Falso Aneurisma/etiologia Falso Aneurisma/fisiopatologia Falso Aneurisma/terapia Fístula Arteriovenosa/diagnóstico Fístula Arteriovenosa/etiologia Fístula Arteriovenosa/fisiopatologia Fístula Arteriovenosa/terapia Diagnóstico Diferencial Diarreia/etiologia Seres Humanos Hipertensão Portal/etiologia Masculino Tomografia Computadorizada por Raios X/métodos Resultado do Tratamento
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[Pt] Tipo de publicação: | CASE REPORTS; JOURNAL ARTICLE |
[Em] Mês de entrada: | 1802 |
[Cu] Atualização por classe: | 180222 |
[Lr] Data última revisão:
| 180222 |
[Sb] Subgrupo de revista: | AIM; IM |
[Da] Data de entrada para processamento: | 180215 |
[St] Status: | MEDLINE |
[do] DOI: | 10.1097/MD.0000000000009893 |
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